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塞尔维亚普通人群样本中抑郁的筛查:传统患者健康问卷-9 截断分数的替代方法。

Screening for depression in the Serbian general population sample: an alternative to the traditional patient health questionnaire-9 cut-off score.

机构信息

Department of Psychology, Faculty of Philosophy, University of Novi Sad, Novi Sad 21 000, Serbia.

Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade 11 000, Serbia.

出版信息

J Public Health (Oxf). 2024 Feb 23;46(1):e15-e22. doi: 10.1093/pubmed/fdad204.

Abstract

BACKGROUND

The Patient Health Questionnaire (PHQ-9) score ≥ 10 balances best sensitivity and specificity when detecting probable depression in patients. In the general population, different cut-offs are suggested. European studies on general populations validating the PHQ-9 against a diagnostic interview to detect depression are rare.

METHODS

This was a cross-sectional observational epidemiological survey using multistage household probabilistic sampling to recruit a representative adult sample (N = 1203; age = 43.7 ± 13.6; 48.7% male). Mental disorders including current major depressive episode (MDE) were observer-rated (Mini International Neuropsychiatric Interview). The PHQ-9, quality of life (QoL), and loneliness were self-assessed. We performed validity and reliability tests of the PHQ-9 and receiver operating curve (ROC) analysis.

RESULTS

The Serbian PHQ-9 was internally consistent and correlated in the expected directions with QoL and loneliness. At the cut-off score ≥ 8, sensitivity was .85 and specificity was .91. ROC analysis showed that the area under the curve was .95, indicating that the Serbian PHQ-9 can discriminate very well between persons with/without MDE.

CONCLUSIONS

When the PHQ-9 is assessed against the structured diagnostic interview in the general population to detect depression, the cut-off of ≥8 balances best sensitivity and specificity.

摘要

背景

当用于检测患者中可能存在的抑郁症时,患者健康问卷(PHQ-9)得分≥10 在灵敏度和特异性方面达到最佳平衡。在普通人群中,建议使用不同的截断值。在普通人群中针对抑郁症进行诊断访谈验证 PHQ-9 的欧洲研究很少。

方法

这是一项使用多阶段家庭概率抽样招募代表性成年样本(N=1203;年龄=43.7±13.6;48.7%为男性)的横断面观察性流行病学调查。包括当前主要抑郁发作(MDE)在内的精神障碍由观察者(Mini 国际神经精神访谈)进行评定。PHQ-9、生活质量(QoL)和孤独感由自我评估。我们对 PHQ-9 进行了有效性和可靠性测试,并进行了接收器操作曲线(ROC)分析。

结果

塞尔维亚的 PHQ-9 具有内部一致性,并与 QoL 和孤独感呈预期方向相关。在截断值≥8 时,灵敏度为 0.85,特异性为 0.91。ROC 分析表明曲线下面积为 0.95,表明塞尔维亚 PHQ-9 可以很好地区分有/无 MDE 的人群。

结论

当在普通人群中使用结构化诊断访谈评估 PHQ-9 以检测抑郁症时,截断值≥8 可达到最佳的灵敏度和特异性平衡。

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